Clinical Profile of Atypical Manifestations of Diseases in Elderly Patients Admitted to Critical Care Areas

Background: As the life expectancy goes up, it brings new challenges and dimensions, especially in a developing country like ours. In India, the geriatric age group above 60 years is expected to double from 7.7% in 2001 to 12.30% in 2025. Diseases may present in an atypical manner in elderly. Materials and Methods: This is a prospective, longitudinal, observational, descriptive study. “Geriatric patients” defined as aged 60 years and older, from both sexes were enrolled for this study over a period of 2-years. Results: Of the 10,560 patients admitted under general internal medicine during the study period, 32.76% of cases, i.e., 3450 patients qualified to be called as “geriatric patients,” of whom 710 patients, i.e., 20.58% of the geriatric admissions were in critical care areas. Nearly 55%, of the patients, stayed in the intensive care unit (ICU) setting inclusive of ICU, respiratory ICU and intensive coronary care unit (ICCU) during the study period of whom 61.8% of the subjects presented with typical symptoms and the rest presented with atypical symptoms. A higher death rate among elderly presenting with atypical manifestations was observed. 30.42% of the patients were admitted to ICCU with nearly two-thirds presenting typically and one-third atypically and stayed for a mean duration of 3.17 and 3.54 days, respectively. Conclusion: Clinical presentations and outcome of diseases may be different in geriatric age group as a result of which the diagnosis and management process of critical illnesses in the elderly population may become difficult and complicated. An awareness of atypical manifestations and hence high index of suspicion is a must while managing elderly patients.